CDC says it missed opportunities to contain Ebola

FORT WORTH, Texas — In the days after the first diagnosis of Ebola in the U.S., the head of the Centers for Disease Control and Prevention was resolute in his confidence about hospitals’ ability to manage the virus.

“Essentially any hospital in the country can take care of Ebola. You don’t need a special hospital room to do it,” Dr. Tom Frieden said Oct. 2. “You do need a private room with a private bathroom. And most importantly, you need rigorous, meticulous training and materials to make sure that care is done safely so that caregivers aren’t at risk.”

Less than two weeks later, Frieden admitted that the government wasn’t aggressive enough in managing Ebola and containing the virus as it spread from an infected patient to a nurse at a Dallas hospital.

“We could’ve sent a more robust hospital infection control team and been more hands-on with the hospital from day one about exactly how this should be managed,” he said Tuesday.

Frieden outlined new steps designed to stop the spread of the disease, including the creation of an Ebola response team, increased training for health care workers nationwide and changes at the Texas hospital to minimize the risk of more infections.

“I wish we had put a team like this on the ground the day the patient — the first patient — was diagnosed. That might have prevented this infection,” Frieden said.

The stark admission came as the World Health Organization projected the pace of infections accelerating in West Africa to as many as 10,000 new cases a week within two months.

In a conference call late Tuesday, Oct. 14, the nation’s largest nurses’ union described how the patient, Thomas Eric Duncan, was left in an open area of the emergency room for hours. National Nurses United, citing unnamed nurses, said staff treated Duncan for days without the correct protective gear, that hazardous waste was allowed to pile up to the ceiling and safety protocols constantly changed.

RoseAnn DeMoro, executive director of Nurses United, refused to say how many nurses made the statement about Texas Health Presbyterian Hospital, but insisted they were in a position to know what happened.

A total of 76 people at the hospital might have been exposed to Duncan, and all of them are being monitored for fever and other symptoms daily, Frieden said. Nurse Nina Pham contracted the virus while caring for Duncan. Health officials are monitoring 48 others who had some contact with Duncan before he was admitted the hospital where he died Oct. 8.

The Associated Press reported Monday, Oct. 13,that Pham was among about 70 hospital staffers who were involved in Duncan’s care after he was hospitalized, based on medical records provided by his family.

Frieden said some of the world’s leading experts on how to treat Ebola and protect health care workers are in the new response team. They will review several issues including how isolation rooms are laid out, what protective equipment health workers use, waste management and decontamination.

In Europe, the WHO said the death rate in the outbreak has risen to 70 percent as it has killed nearly 4,500 people, most of them in West Africa. The previous mortality rate was about 50 percent.

President Barack Obama, speaking at the end of a meeting with U.S. and allied military leaders, declared that the “the world is not doing enough” to fight Ebola.

Pham, 26, became the first person to contract the disease on U.S. soil as she cared for Duncan. The nurse released a statement Tuesday through Texas Health Presbyterian Hospital saying she was “doing well,” and the hospital listed her in good condition. She has received a plasma transfusion from a doctor who beat the virus and the hospital CEO said medical staff members remain hopeful about her condition.

Pham was in Duncan’s room often, from the day he was placed in intensive care until the day before he died.

“I’m doing well and want to thank everyone for their kind wishes and prayers,” she said.

Pham’s parents live in Fort Worth, where they are part of a close-knit, deeply religious community of Vietnamese Catholics. Members of their church held a special Mass for her Monday and her sorority sisters at the Texas Christian University held a candlelight vigil for her Tuesday.

Pham and other health care workers wore protective gear, including gowns, gloves, masks and face shields — and sometimes full-body suits — when caring for Duncan. Health officials have said there was a breach in protocol that led to the infections, but they don’t know where the breakdown occurred.

Among the changes announced Tuesday by Frieden was a plan to limit the number of health care workers who care for Ebola patients so they “can become more familiar and more systematic in how they put on and take off protective equipment, and they can become more comfortable in a healthy way with providing care in the isolation unit.”

Frieden said he was fully aware of the fear among health care workers in Texas and elsewhere about the risks of contracting the virus. He said an on-site manager who is an expert in infectious diseases will take charge, and health care workers will undergo new training.

“Ebola is unfamiliar. It’s scary, and getting it right is really, really important because the stakes are so high,” he said.